Content
Opaque enema is a diagnostic test that uses X-rays and contrasts, usually barium sulphate, to study the shape and function of the large and rectal intestines and, thus, to detect possible intestinal problems, such as diverticulitis or polyps, for example.
The opaque enema exam can be done in both adults and children and can be divided into a simple opaque enema, when using only one contrast, and an opaque enema with double contrast, when more than one type of contrast is used.
To perform the examination, it is important that the person follows the doctor's recommendations, such as fasting and intestinal cleaning so that the intestine can be correctly visualized.
What is it for
The examination of opaque enema is indicated to investigate possible changes in the intestine, so the gastroenterologist can recommend its performance when there is suspicion of colitis, bowel cancer, tumors in the intestine, diverticulitis which is the inflammation of the folds of the intestine walls, it is characterized by the distorted intestine, or the presence of intestinal polyps.
In children, the indications for the opaque enema test may be chronic constipation, chronic diarrhea, bloody stools or chronic pain in the abdomen, as well as being indicated as a form of screening for children who will be submitted to rectal biopsy due to suspicion. Hirschsprung's syndrome, also known as congenital megacolon, in which there is an absence of nerve fibers in the intestine, preventing the passage of feces. Learn more about the congenital megacolon.
Preparation for the opaque enema exam
To perform the opaque enema exam, it is important that the person follows some guidelines from the doctor, such as:
- Fasting about 8 to 10 hours before the exam;
- Do not smoke or chew gum while fasting;
- Take a laxative in the form of a pill or suppository the day before to clean your intestines;
- Eat a liquid diet the day before the exam, as directed by the doctor.
These precautions are important because the intestine must be completely clean, without residues of feces or gauze, in order to be able to see the changes.
Preparing for the enema opaque in children over 2 years of age includes offering plenty of fluids during the day and giving magnesium milk after dinner the day before the exam. If the exam was requested because of chronic constipation or megacolon, preparation is not necessary.
How the exam is done
The opaque enema exam lasts about 40 minutes and is performed without anesthesia, which can make the person feel pain and discomfort during the exam. Therefore, some doctors prefer to request a colonoscopy because it also serves to assess the large intestine, being safer and more comfortable for the patient.
The opaque enema exam is performed according to the following steps:
- Performing a simple X-ray of the abdomen to check that the intestine is properly cleaned;
- The person is placed lying on the left side, with the body tilted forward and the right leg in front of the left leg;
- Introduction of a rectal and contrast probe, which is barium sulfate;
- The person is repositioned so that the contrast can be spread;
- Removal of excess contrast and air injection;
- Probe removal;
- Performing several x-rays to assess the intestine.
During the exam, the person may feel like having a bowel movement, especially after the air injection and, after the exam, they may experience swelling and pain in the abdomen and an urgent desire to have a bowel movement. It is normal for the person to have constipation for a few days and the stools become white or gray due to the contrast, so it is very important to increase the consumption of foods rich in fiber, such as whole grains and unpeeled fruits, and to drink 2 liters of water a day.
In the case of children, this can also happen, so it is important for parents to offer the child plenty of fluids after the exam.
Created by: Tua Saúde Editorial Team
Bibliography>
- ANDRADE, Vera Lúcia A. et al. Topographic evaluation of the transverse colon by the opaque enema: definition, prevalence and proposal for the classification of transverse colon ptosis. GED gastroenterol. endosc. dig. Vol 33. 3rd ed; 83-87, 2014
- PEYVASTEH, Mehran et al. Accuracy of diagnosis of opaque enema findings in Hirschprung's disease. ABCD Arq Bras Cir Dig. Vol 29. 3rd ed; 155-158, 2016
- FACULTY OF MEDICINE OF BOTUCATU. Technical peculiarities for performing opaque enema in the diagnostic investigation of Hirschsprung's Disease. 2015. Available at:. Accessed on 17 Apr 2020